Provider Demographics
NPI:1215418843
Name:ACEVEDO, DAPHNE MICHELLE
Entity Type:Individual
Prefix:
First Name:DAPHNE
Middle Name:MICHELLE
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 GRANT AVE APT 2L
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3624
Mailing Address - Country:US
Mailing Address - Phone:914-406-9025
Mailing Address - Fax:
Practice Address - Street 1:80 GRANT AVE APT 2L
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-3624
Practice Address - Country:US
Practice Address - Phone:914-406-9025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency